Early results of surgery in patients considered cimetidine failures

Fifty‐two consecutive unselected duodenal ulcer patients (Group 1), who had failed to respond to cimetidine and who subsequently underwent elective vagotomy and drainage, were studied. All patients were symptomatic on cimetidine in full recommended dosage. This group has been compared with another group of 634 duodenal ulcer patients (Group 2) undergoing elective vagotomy and drainage in the ‘pre‐cimetidine era’. The groups were similar pre‐operatively with regard to age, sex, length of history and maximal acid output. Completeness of vagotomy and amount of acid reduction were similar in the two groups. The incidence of recurrent ulceration was 5 per cent in Group 1 and 5.7 per cent in Group 2. Although, of necessity, follow‐up is shorter in the cimetidine failures (mean 2.3 years), there is nothing to suggest that failure to respond to cimetidine precludes a satisfactory surgical result.